Please complete the eForm below. Please be sure to upload a signed authorization as well as any other forms needing completion.

University of Michigan Employee Information:

University of Michigan Employee First Name

University of Michigan Employee Last Name

Employee's Phone Number:

Employee's Email:

If known, please list the employee's eight digit University of Michigan ID number.

University of Michigan Employee - Full SSN

Were you employed prior to 2001?

Employee Report Sample

https://ssc.umichsites.org/wp-content/uploads/s...

Please select the employment verification below that suits your needs:

Automated Employment Report (see sample above)

Public Service Loan Forgiveness (PSLF) Certification and/or Application

Other

Please Note - Regarding PSLF submissions:

If you have selected PSLF, please be sure your Page 1 is complete & Page 2 is authentically signed and dated no older than 90 days (see signature guidelines on the Federal Student Aid website (https://studentaid.gov/manage-loans/forgiveness... Click here for a blank Page 1 -2 (https://studentaid.gov/sites/default/files/publ...

For all other employment verification requests, please upload a signed authorization document. Requests that do not include a filled out AND signed authorization form will be returned without processing. Click here for a blank authorization form (https://ssc.umich.edu/wp-content/uploads/sites/...

The Shared Services Center does not determine eligibility for the PSLF program and does not receive status updates after submission. Further questions should be directed to the Federal Student Aid Information Center (FSAIC) at: 1-800-433-3243 and/or MOHELA at: 855-265-4038, or by using your MOHELA account online. For more information on the University of Michigan’s PSLF process, please visit the PSLF page of our website (https://ssc.umich.edu/human-resources/public-se...

To attach files, click Browse, navigate to the file(s) you'd like to attach, and click Open. Attached files will appear in the Attachment space provided.

Please provide more details for your VOE request.

Requested Information

Hire Date

Termination Date (if applicable)

Current and/or Final Job Title(s)

Specific Job Title(s) and/or Specific Date(s)

Full Employment History

Standard Hours & Full-time vs. part-time

Salary/Hourly Rate

Pay Frequency (biweekly or monthly)

Gross earnings from ________ to _______

Specific Job Title(s) and/or Specific Date(s):

Gross earnings start date

Gross earnings end date

Have you previously verified your University of Michigan employment for the PSLF program?

Yes, I am recertifying

No, please certify my qualifying employment

Unsure

Did any portion of your University of Michigan appointment(s) total less than 30 hrs per week?

Yes

No

Did you work anywhere else while working less than 30 standard hours per week at the University of Michigan?

Yes

No

Do you need your completed PSLF faxed?

Yes - Fax to US Department of Education

No - Return completed page 3 to me only

Please Note:

Your application will be faxed to the US Department of Education at 540-212-2415. A copy of your completed application will be shared with you via Dropbox.

Please Note:

Your page 3 will be completed and returned to you via Dropbox. You will be responsible for submitting your application to the Department of Education

Where should we send your request:

Your Company Name:

Company Email Address:

If you have selected PSLF, please be sure your Page 1 is complete & Page 2 is authentically signed and dated no older than 90 days (see signature guidelines on the Federal Student Aid website). Click here for a blank Page 1 -2.

For all other employment verification requests, please upload a signed authorization document. Requests that do not include a filled out AND signed authorization form will be returned without processing. Click here for a blank authorization form.

The Shared Services Center does not determine eligibility for the PSLF program and does not receive status updates after submission. Further questions should be directed to the Federal Student Aid Information Center (FSAIC) at: 1-800-433-3243 and/or MOHELA at: 855-265-4038, or by using your MOHELA account online. For more information on the University of Michigan’s PSLF process, please visit the PSLF page of our website.

To attach files, click Browse, navigate to the file(s) you'd like to attach, and click Open. Attached files will appear in the Attachment space provided.

Attachment

*Authorization
*Form

Browse...

Description

The full details of a ticket, including any appropriate circumstances or supplementary information that may aid in resolving it.

Please allow up to five business days for processing your request. We appreciate your patience.

Your name

Your email address

Verification Code

SSC-HR-Former Employees Data Request

University of Michigan Employee Information:

Other Fields